I obtained Government approval in July 2018 for the Sláintecare Implementation Strategy to deliver the vision outlined for our health system in the Sláintecare Report produced by the Future Healthcare Committee.
The Implementation Strategy recognises that strong leadership and clear governance will be essential to success and it clearly sets out the implementation and governance structures for Sláintecare. The Minister for Health is accountable to the Oireachtas for implementation and will report regularly on progress. The Cabinet Committee on Health, chaired by the Taoiseach will provide overall strategic direction and will oversee implementation, ensuring leadership at the highest level.
The Sláintecare Programme Implementation Office was established in the Department of Health, and drives the implementation of the Strategy. The office is led by an Executive Director, and is resourced with a team to deliver the reform programme. The Office has established the programme of reform as approved by Government and has begun to put in place the governance arrangements, processes, structures and resources to implement the reform across 2018 and 2019.
The goal of the agreed Oireachtas all-party 10-year plan for Sláintecare is to enable the delivery of the Right Care, in the Right Place at the Right Time by the Right Team, at low or no cost. The 2019 Sláintecare Action Plan set out detailed timeframes for 138 projects that were to be progressed in 2019, as the first full year in the implementation of the Sláintecare vision, and firmly established a programmatic approach to the delivery of the Sláintecare strategy. Of the 138 projects for the period up to December 2019, 112 were on track, 24 have been progressed with minor challenges, and 2 with significant challenge. This work has been carried out by many stakeholders, including from the Department of Health, the HSE, the voluntary and community bodies and key partners. It represents a concerted effort to deliver on the all-party vision and provides a strong foundation for moving forward into 2020, and beyond.
Foundational Decisions in 2019
During 2019, a series of important Sláintecare reform Government decisions have been made, including the agreement:
1. on the geographies for the six new regional health areas which is a first major step towards restructuring our health services in line with recommendation in the Oireachtas Committee report, which is informing the development of a detailed business case for consideration by Government;
2. to support the findings of the Independent Review Group established to examine private activity in public hospitals with the decision and announcement that all future consultant appointments, from mid-2020, will be to the new Sláintecare Consultant contract for public only work;
3. on revised GP contractual arrangements in April 2019, which will see a €210 million investment (40% increase) in General Practice over the next four years of which €80 million will be available for the management of chronic diseases, like diabetes and COPD, through family doctors. This is expected to benefit more than 400,000 patients;
4. on the strengthening of the HSE with the formal appointment of the Health Service Executive (HSE) Board in June 2019 and the introduction of a new HSE Chief Executive Officer.
Moving into the second full year of implementation and building on the foundations put in place in 2019, the Sláintecare Programme will work on three priority reform programmes for 2020. These programmes are carefully planned to be delivered over a number of years, and will:
- continue the reorganisation of the HSE into Regional Health Areas, which will deliver integrated patient-centred services that are safe, local and fairly distributed;
- implement the recommendations of the Capacity Review 2018, encompassing both investment, as well as resource optimisation which will reduce waiting times and develop extra capacity for population growth in the health and social care system; and
- examine the eligibility and entitlement to health and social care services of our citizens to make sure cost is not a barrier to getting care in a timely manner.
The past year has seen the delivery of the majority of actions committed for 2019, the first full year of the ten-year Sláintecare strategy. To succeed, Sláintecare requires the long-term commitment of targeted and protected funding and support to enable the delivery of the reform programme. This funding will be invested strategically and will support the overall vision for reform, with a consistent focus on effectiveness, efficiency and value for money. In parallel, with Government commitment to funding, there is a requirement on all parts of the health delivery system to optimise the use of the scarce resources already made available to it. Thus, a two-pronged approach to reform is being undertaken: one of investment and one of resource optimisation.